Foot Biomechanics, Healthy Volunteers
Conditions
Keywords
Footwear, Balance, Plantar Pressure, Healthy Adults
Brief summary
Footwear is one of the most important external factors influencing lower extremity biomechanics, plantar sensory feedback, and postural control. Although supportive footwear provides cushioning and arch support, prolonged use may reduce intrinsic foot muscle activity and alter natural foot mechanics. Conversely, flat footwear may enhance plantar sensory input and foot muscle activation. However, evidence regarding the long-term biomechanical effects of habitual footwear use in healthy adults remains inconsistent. This cross-sectional comparative study aims to compare foot posture, plantar pressure distribution, and balance performance between healthy adults who have regularly worn supportive footwear or flat footwear for at least six months. Static plantar pressure distribution will be assessed using the Footwork system, while static and dynamic balance will be evaluated using the Biodex Balance System. The findings are expected to improve understanding of the long-term biomechanical consequences of habitual footwear selection.
Detailed description
Footwear is one of the most influential external factors affecting lower extremity biomechanics, plantar sensory feedback, and postural control during daily activities. Modern footwear designs differ considerably in their structural characteristics, including cushioning, arch support, sole stiffness, and heel height. These features may alter foot mechanics, proprioceptive input, and neuromuscular control, potentially leading to long-term adaptations in balance and movement patterns. Supportive footwear is designed to improve comfort and reduce plantar loading through enhanced cushioning and medial arch support. However, prolonged use has been suggested to limit the natural motion of the foot and reduce activation of the intrinsic foot muscles. In contrast, flat footwear provides minimal structural support, allowing greater interaction between the plantar surface and the ground, which may enhance sensory feedback and promote more natural foot function. Despite increasing interest in footwear biomechanics, evidence regarding the long-term effects of habitual footwear use in healthy individuals remains limited and inconsistent. Most previous studies have focused on the immediate effects of different shoe designs during walking or running, whereas few have investigated the chronic adaptations associated with everyday footwear habits. Furthermore, objective assessments combining plantar pressure analysis and computerized balance evaluation have rarely been used to compare individuals with different long-term footwear preferences. The aim of this cross-sectional comparative study is to investigate whether habitual use of supportive or flat footwear is associated with differences in foot posture, plantar pressure distribution, and postural stability in healthy adults. Participants aged 18 to 35 years who have consistently worn either supportive or flat footwear for at least six months, for a minimum of six hours per day, will be recruited from the Faculty of Health Sciences at Bahçeşehir University. Following informed consent, demographic characteristics, anthropometric measurements, and footwear history will be recorded. Static plantar pressure distribution and foot posture characteristics will be assessed using the Footwork Pedobarography System. Static and dynamic balance performance will be evaluated using the Biodex Balance System. Balance measurements will include double-leg and single-leg standing assessments, and objective stability indices will be recorded according to standardized testing protocols. The primary outcomes will be the Overall Stability Index obtained from the Biodex Balance System and plantar pressure distribution parameters measured using the Footwork Pedobarography System. Secondary outcomes will include anterior-posterior and medial-lateral stability indices, foot contact area, arch-related plantar pressure characteristics, and balance performance during single-leg and double-leg stance. It is hypothesized that individuals who habitually wear flat footwear will demonstrate different plantar pressure characteristics and balance performance compared with those who regularly wear supportive footwear, reflecting long-term biomechanical adaptations associated with footwear selection. The findings of this study are expected to improve understanding of the relationship between habitual footwear use and lower extremity biomechanics in healthy adults. The results may contribute to evidence-based recommendations regarding footwear selection and support preventive strategies in physiotherapy, rehabilitation, sports medicine, and footwear design. Additionally, this study may provide a scientific basis for future longitudinal and interventional research investigating the long-term musculoskeletal consequences of everyday footwear habits.
Interventions
None listed
Sponsors
Bahçeşehir University
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 35 Years
Healthy volunteers
Yes
Inclusion criteria
* Adults aged 18 years and older * Diagnosis of hemophilia A or B * Scheduled to undergo primary total knee arthroplasty * Able to understand the study procedures and provide written informed consent * Willing to participate in the prehabilitation program
Exclusion criteria
* Presence of neurological disorders affecting balance or gait * Severe cognitive impairment * Other musculoskeletal conditions affecting lower extremity function * Revision total knee arthroplasty * Any medical condition that would prevent safe participation in the exercise program
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Stability Index (OSI) | Baseline | Overall Stability Index measured using the Biodex Balance System. |
| Plantar Pressure Distribution | Baseline | Static plantar pressure distribution assessed using the Footwork Pedobarography System. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Foot Contact Area | baseline | Foot contact area will be assessed using the Footwork Pro pressure plate system (Footwork®, AM CUBE, France). Participants will stand barefoot on the pressure platform during the assessment. The system will record the plantar contact area (cm²) of each foot using computerized baropodometric analysis. Higher values indicate a larger plantar contact area during static standing. |
| Arch Index | Baseline | The Arch Index is a footprint-based measure used to classify foot arch height. It is calculated as the ratio of the midfoot contact area to the total footprint area (excluding the toes). Scores range from 0 to 1, with higher values indicating a flatter foot (lower medial longitudinal arch) and lower values indicating a higher medial longitudinal arch. |
| Anterior-Posterior Stability Index | Baseline | Anterior-Posterior Stability Index is a measure of postural stability in the sagittal plane, assessed using the Biodex Balance System. Scores typically range from 0 upward, with lower scores indicating better postural stability (less sway) and higher scores indicating poorer postural stability (greater sway). |
| Single-leg Balance | Baseline | Static balance is assessed by measuring the time participants can maintain a one-legged stance. Scores range from 0 to 30 seconds, with higher scores indicating better static balance. |
Countries
Turkey (Türkiye)
Contacts
CONTACTTuğçe Poyraz İşleyen, Asst.Prof.
Outcome results
None listed